Most of the side effects related to the use of NSAIDs such as diclofenac, naproxen, indomethacin... are due to these drugs non-selectively inhibiting both the enzyme Cyclooxygenase (COX)-1, which plays a role in maintaining the normal physiological function of tissues/organs, rather than only inhibiting COX-2, which is abundant at the site of inflammation. In a normal physiological state, the enzyme COX-1 is expressed and functions in which of the following tissues/organs, EXCEPT?

Most anesthetics, sedatives, and sleeping drugs are active substances that inhibit the central nervous system (CNS) by increasing the effect on GABA receptors and/or antagonizing the receptors of glutamate (NMDA receptors). Which of the following statements is correct about GABA and glutamate?

Which side effect of lidocaine is at risk of occurring and must be monitored carefully in this situation, EXCEPT?

A 45-year-old male patient is in the post-operative room after a leg skin surgery and complains of severe pain. The doctor decides to start intramuscular injections of morphine (an opioid pain reliever) to alleviate the patient's pain as needed and asks the nurse to closely monitor the daily dosage of morphine required to relieve the patient's pain. This is very important because morphine can quickly cause which of the following phenomena?

In addition to using NSAID anti-inflammatory pain relievers, cleaning the wound is also very important to help quickly reduce the symptoms of swelling, heat, redness, and pain caused by the wound. This regular cleaning of the wound helps to significantly reduce the metabolites through the arachidonic acid metabolic pathway by the enzymes cyclooxygenase-2 and lipoxygenase, which produce inflammatory-pain mediators such as prostaglandin and leukotriene. Which of the following factors of the damaged tissue is the starting point of this arachidonic acid metabolic pathway?

A 56-year-old male patient was admitted to the hospital due to coughing up blood-stained sputum for the past 2 days. On the day of admission, the patient's body temperature was 39°C. Clinical examination and chest X-ray showed signs of pneumonia. Examination of the sputum sample revealed many gram-positive pneumococci, Streptococcus pneumoniae. The doctor prescribed an intravenous injection of a penicillin group antibiotic, ampicillin/sulbactam 1g/0.5g to be administered every 6 hours and noted that the nursing staff should closely monitor the patient during and after the infusion, especially the initial dose. Which of the following reactions in the patient need to be closely monitored in this case?

A 26-year-old female patient is suffering from sepsis caused by methicillin-resistant Staphylococcus aureus (MRSA) and is prescribed vancomycin 500 mg intravenous infusion every 8 hours. The doctor clearly notes for the nurse to administer the infusion slowly over 60 minutes (absolutely not shorter than 30 minutes) to avoid a side effect of vancomycin occurring for the patient when infused quickly. Which side effect is being referred to in this case?

A patient with septicemia caused by Pseudomonas aeruginosa is being treated with an aminoglycoside antibiotic, gentamicin. Due to the patient's inadequate clinical response, the doctor prescribes an additional beta-lactam antibiotic, piperacillin/tazobactam, with a note that it must be administered separately via a different intravenous line. If the nurse accidentally administers it through the same line as gentamicin, what risk may occur?

Which treatment for tuberculosis can help improve patient compliance and reduce the development of antibiotic resistance?

A male patient, 80 years old, hospitalized with impaired kidney function, has a creatinine clearance test result of 25 mL/min and is suffering from pneumonia that requires treatment with antibiotics. Which antibiotic/antifungal should the nurse be cautious about when prescribed by the doctor for this patient, EXCEPT?

Nurses, when carrying out medication orders in the treatment and care of patients, need to pay special attention to high-alert medications due to the high risk of causing significant adverse reactions to patients if used improperly and/or incorrectly. Which of the following medications belongs to the group of high-alert medications, EXCEPT?

A 23-year-old male patient has been diagnosed with type 1 diabetes. Which of the following medications is most appropriate to initiate treatment to control blood sugar for this patient?

A 35-year-old female patient was diagnosed with systemic lupus erythematosus and was prescribed an anti-inflammatory corticosteroid medication, prednisone 200 mg/day during the first week in the hospital and after discharge maintained at a dose of 80 mg/day, taken every other day. The nurse needs to note the optimal time for the patient to take the medication during maintenance treatment after discharge?

Prednisone (a drug belonging to the glucocorticoid group) has just been prescribed by the doctor for a type 1 diabetic patient who is taking Humulin (regular insulin) every day. What change should the nurse be aware of in this patient with the new treatment regimen?

Glucotrol (active ingredient glipizide, sulfonylurea group) is indicated for a patient with type 2 diabetes. The nurse needs to instruct the patient to avoid which of the following foods or drinks?

A diabetic patient is being prescribed subcutaneous insulin glargine injections daily by the doctor. The nurse instructs the patient that this medication controls blood sugar for how long?

T.V.D has just been diagnosed with type 1 diabetes. What should the nurse know about this disease when guiding the patient on medication use?

Which of the following is a major side effect of insulin that can threaten the patient's life?

Symptoms of hypoglycemia in diabetic patients being treated with insulin?

A patient is using an oral contraceptive pill daily, in the form of a tablet containing derivatives of both estrogen and progestin. In the case that the patient uses which of the following medications, it is necessary to be cautious due to its impact on the contraceptive effectiveness of the medication being used?

N.T.T has just been diagnosed with type 1 diabetes and has been prescribed subcutaneous insulin injections daily (self-injectable pen) for treatment. The nurse needs to guide the patient on how to self-inject insulin in order to avoid side effects causing lipodystrophy at the injection site?

As a healthcare worker, a nurse needs to know that the treatment regimen with corticosteroid drugs is used in the following pathological conditions, EXCEPT?

Corticosteroid derivatives can be mixed with herbal pills of unknown origin. The abuse of these drugs can lead to which syndrome?

Abuse and/or prolonged use of hormonal drugs such as corticosteroids, sex hormones, etc. can lead to the suppression of the normal physiological activity of which system in the body?

An 8-year-old child patient with severe asthma has been prescribed Ventolin® (Salbutamol) inhaler during asthma attacks, and Seretide® 25/50 (Salmeterol/Fluticasone) inhaler twice a day (morning-evening). The nurse needs to remind the parents (or guardians) of this child about the most important thing below?

A 58-year-old male patient with a history of hypertension and currently on medication has just been diagnosed with benign prostatic hyperplasia after visiting for difficulty urinating and intermittent urination. The doctor prescribed an alpha-1 adrenergic antagonist, Terazosin, to help alleviate the patient's symptoms. The nurse needs to pay attention to which of the following for this patient upon discharge?

A patient with hyperthyroidism is prescribed Propylthiouracil (an antithyroid drug) and Propranolol (a beta-1 adrenergic receptor blocker) by the doctor. The patient asks you, a nurse, to explain which symptom Propranolol helps to reduce for the patient?

A 32-year-old male patient was admitted to the emergency room due to pesticide poisoning. It is known that the pesticide has a strong and potentially irreversible inhibitory effect on the enzyme Acetylcholinesterase (AChE). The doctor administered the antidotes Pralidoxime (2-PAM) and Atropine and requested you to monitor the effectiveness by examining the patient's fundus. What finding will be recorded during the fundus examination in this case of pesticide poisoning?

Which type 2 diabetes medication below helps increase insulin sensitivity (reduce insulin resistance) and is the preferred first-line treatment when starting therapy?

Which of the following indices can help monitor and objectively assess the treatment adherence of patients with type 2 diabetes?

Classic H1 antihistamines like Diphenhydramine are also commonly used as anti-nausea and motion sickness medications due to which of the following effects?

A patient has a duodenal ulcer due to increased gastric secretion and is prescribed a proton pump inhibitor, Esomeprazole in capsule form, for treatment. Which of the following instructions helps the patient use the medication most effectively, EXCEPT?

Which of the following is the most appropriate and important when a nurse carries out the medication order for digoxin in a cardiovascular patient?

Epinephrine is used to treat cardiac arrest and severe acute asthma attacks due to which of the following effects?

Which calcium channel blocker has the strongest effect in causing vasodilation of smooth muscle and often leads to excessive hypotension?

Which of the following side effects is commonly encountered in elderly patients who experience fluid loss when using the diuretic Furosemide in the treatment of cardiovascular disease?

What is the main pharmacological effect of calcium channel blockers that helps to lower blood pressure?

A hospitalized patient in the general internal medicine department is starting to use a drug from the specific beta-1 adrenergic receptor blocker group (ß1 blocker). What monitoring should the nurse perform, EXCEPT:

What pharmacological effects do angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) have on the renin-angiotensin-aldosterone system?

A nurse is preparing to carry out a medication order to initiate treatment with an angiotensin-converting enzyme inhibitor (ACEI) for a cardiovascular patient. When starting this patient on this ACEI for the first time, the nurse needs to monitor which of the following risks in the patient:

A nurse is caring for a cardiovascular patient with an angiotensin-converting enzyme inhibitor (ACEI). Which of the following information from the patient should the nurse consider adjusting to ensure the patient uses this medication safely and effectively?

Which vascular dilators are primarily used in the treatment of which of the following conditions?

Which cardiovascular patient below is most likely to experience side effects from diuretic treatment?

A nurse is checking the medication orders and records of a cardiovascular patient, which includes a lipid-lowering drug from the statin group. What is the most important effect of this statin drug?

Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) act on the renin-angiotensin-aldosterone system, providing long-term benefits in the treatment of cardiovascular diseases. However, these drugs are absolutely contraindicated in the treatment of cardiovascular diseases for which of the following patients?

What is the effectiveness of injectable anticoagulants like heparin due to?

Which of the following drugs is used to counteract the bleeding effects in case of heparin overdose?

Which of the following drugs is used to counteract the bleeding effects in case of warfarin overdose?

A patient is about to start a treatment regimen with intravenous heparin. The nurse carrying out this order needs to check with the pharmacy to ensure which of the following medications must be available before administering heparin?

A nurse is consulting a patient preparing for discharge with a treatment regimen that includes a newly prescribed beta-blocker medication, metoprolol, along with the subcutaneous insulin the patient is using to treat type 1 diabetes. What should the nurse inform the patient about the potential interaction between these two medications?

Hình vẽ sau biểu diễn vai trò phối hợp của đội ngũ điều trị trong việc sử dụng thuốc điều trị cho bệnh nhân. Từ hình vẽ này, hãy cho biết vai trò nào sau đây của điều dưỡng góp phần vào việc sử dụng thuốc an toàn-hiệu quả-hợp lý, NGOẠI TRỪ?

In general, a chemical substance introduced into the body for the purpose of treating a disease is considered a drug or a poison due to the difference in?

With the current knowledge base, the scientific theoretical basis for explaining the effects of drugs on the body is based on?

Which of the following statements best explains the variation (oscillation) in the effects of drugs among individuals in a population despite using the same dosage, form, and route of administration?

A 67-year-old patient was admitted to the hospital due to deep vein thrombosis in the left calf and pulmonary embolism and is being administered intravenous heparin anticoagulant. Due to a medical error, the drip rate was set at a speed 100 times higher than the correct medication administration rate. Which of the following statements about heparin is true, EXCEPT?

Drug molecules often act on multiple different receptors in the body, in addition to the main receptor that is the target of the drug. This explains why drugs often have many other effects, aside from the desired therapeutic effect. Which of the following statements best explains this fact, EXCEPT?

Which route of drug administration has the most variable pharmacokinetics?

Một em bé nhập viện vì ngộ độc aspirin do uống nhầm. Vì aspirin bản chất là một acid yếu, bác sĩ cho gây kiềm hóa nước tiểu bằng cách cho dùng dung dịch bicarbonate. Lý do cho sự kiềm hóa nước tiểu ở bệnh nhân trong trường hợp ngộ độc aspirin?

Một em bé nhập viện vì ngộ độc paracetamol do uống nhầm cách đó khoảng 1 giờ. Bác sĩ cho gây nôn bằng thuốc kích thích nôn. Lý do cho việc kích thích nôn ở bệnh nhân trong trường hợp ngộ độc paracetamol?

Which type of protein in plasma is commonly bound to drugs and significantly affects the distribution of drugs in the body, but often changes in individuals with liver disease that nurses need to pay attention to in care and treatment?

You are a nurse in a case where a patient is diagnosed with severe sepsis and is prescribed continuous intravenous administration of an antibiotic called Aztreonam, which has a half-life of 2 hours, along with an order to take a blood sample for bacterial culture identification. When should the blood sample be taken?

A 39-year-old male patient experiences dull visceral pain and is prescribed a morphine derivative pain reliever, hydrocodone, to alleviate the pain. Initially, the patient was prescribed 2 pills per day, which effectively controlled the pain symptoms. Three days later, the patient had to take 4 pills per day to manage the pain as he did when he was taking 2 pills per day. Which of the following best explains this patient's situation?

Subjective factors, which can be completely prevented by healthcare workers, affect both pharmacokinetic and pharmacodynamic processes of drugs, causing changes in the efficacy and safety of drugs in treatment. Which of the following factors is it?

Which of the following situations is NOT a harmful reaction to a drug?

Which evidence from trials is the most valuable for assessing the efficacy and safety of a new drug?

Many products derived from medicinal herbs are only listed as functional foods, supportive treatment products, and are not considered as drugs for treating diseases due to a lack of scientific evidence from which of the following trials?

Which of the following statements is correct regarding the significance of phase 4 clinical trials (after the drug has been marketed), EXCEPT?

A 6-year-old boy has just been diagnosed with an upper respiratory tract infection and has started treatment with a combination of Amoxicillin + Clavulanic acid. In this formulation, only Amoxicillin, a beta-lactam antibiotic, has a bactericidal effect, while clavulanic acid, when used alone, has no bacteriostatic or bactericidal effect. However, the combination of the two drugs has a much stronger bactericidal effect than when using amoxicillin alone. Which of the following statements best describes the action of Clavulanic acid?

The most valuable evidence from which type of trial to assess the efficacy and safety of a new drug?

A 54-year-old female patient with deep vein thrombosis (DVT) is being treated stably with oral warfarin at a dose of 2.5 mg/day. In the past week, the patient has noticed some bruises on her calves, palms, and some spots on her skin, so she went to the hospital for examination. The patient reported that due to back pain, she took ALAXAN (ibuprofen + paracetamol) for pain relief for 3 days before being admitted to the hospital for examination. This situation indicates that the effect of warfarin is increased due to which of the following phenomena?

You are a nurse in the intensive care unit (ICU) and are required to frequently monitor and report any changes (if any) in laboratory test indicators or clinical changes to the treating physician. Which of the following changes is important when there is an indication to use drugs such as amphotericin B, digoxin, gentamicin, vancomycin?

Using antibiotics effectively, safely, and reasonably will help reduce the risk of which of the following, EXCEPT?

A nurse is participating in a clinical trial evaluating a new drug to treat a previously untreatable disease. The pharmacological trial assessing the drug's effects and safety on a small population group showed that this drug has a therapeutic index (TI) ranging from 1 to 3. Which of the following statements is the most accurate when predicting the drug's effects?

A newly graduated nurse accidentally administers potassium chloride (KCl) instead of sodium chloride (NaCl) to a patient. Which of the following medications is effective for managing this situation?

The following illustration describes the relationship between the concentration and the administration method of a penicillin group antibiotic on a pediatric patient with a total daily dose of 200 mg. Please indicate which method of drug administration is optimal for the patient in this case?

Which type of drug below has the potential to cause drug dependence and addiction that needs to be noted when used, EXCEPT?

Bạn là điều dưỡng viên đang phụ trách chăm sóc-điều trị cho một bệnh nhân bị nhiễm trùng có kèm theo tình trạng suy gan và đang sử dụng một thuốc kháng sinh nhóm Macrolid. Dựa vào kiến thức dược lý bạn đã học, hãy cho biết quá trình dược động học nào của thuốc bị ảnh hưởng và thay đổi nhất ở bệnh nhân này?

What important warnings do the following images and tables provide for nurses when carrying out medication orders for patients, EXCEPT?

For cancer treatment drugs, the dosage of the drug is calculated based on which of the following parameters of the patient?

A 43-year-old patient has just been diagnosed with stage T₄N₃M_x (x means unclear) colon cancer and has been prescribed treatment according to a combination regimen of 3 drugs including oxaliplatin, 5-fluorouracil (5-FU), and leucovorin (folinic acid). Which of the following side effects and/or toxicities of the treatment drugs can be predicted and needs to be advised to the patient, EXCEPT?